Aims:
Dyselectrolytemia is a common problem in patients with terminal cancer. It worsens the quality of life and increases the amount of complications. The aim of our study was to determine factors connected with dyselectrolytemia in patients with terminal cancer.
Methods:
360 terminal cancer patients admitted to Palliative Care Unit were retrospectively analyzed. Detailed physical examination, medical history including history taken from family and care givers was taken upon admission. Laboratory parameters including morphology, concentration of sodium, potassium, total and ionized calcium, LDH were taken on admission. Univariate and multivariate logistic regression analysis was used to determine possible predictors, symptoms and consequences of dyselectrolytemia.
Results:
On admission 68,05% of patients had dyselectrolytemia. They were more frequently admitted to hospital from Emergency Department (OR=Odds Ratio=2,83;CI95%=Confidence Interval 95%=1,772-4,52;p=probability value=0,00001), had higher PS scale note (OR=1,702;CI95%=1,35-2,145;p=0,0013), were more often cachectic (OR=2,094;CI95%=1,335-3,284;p=0,0013), more often constipation (OR=1,847;CI95%=1,177-2,9;p=0,0077), were more often dehydrated (OR=2,483;CI95%=1,489-4,139;p=0,0005), lower albumin level (OR=0,909;CI95%=0,874-0,945;p=0,000001), more often administration of opioids (OR=2,313;CI95%=1,345-3,98;p=0,0024). Multivariate logistic regression analysis after adjustment for possible confounders reviled that admission to hospital from Emergency Department (OR=2,72;CI95%=1,574-4,697;p=0,0003), opioids administration (OR=2,314;CI95%=1,22-4,387;p=0,01), occurrence of cachexia (OR=1,865;CI95%=1,091-3,19;p=0,023) and higher risk of death (OR=2,265;CI95%=1,327-3,868;p=0,003) remained independently associated with dyselectrolytemia.
Conclusions:
Occurrence of cachexia, opioids administration and admission to hospital from Emergency Department are factors associated with dyselectrolytemia. Patients with electrolytes imbalances had 226% higher risk of death.
Project "Extension of life and improvement of its quality and reduction of cancer patients' mortality due to proper control of water and electrolyte management and elimination of risk factors for dehydration and dyselectrolytemia." co-financed by the European Social Fund under the project of the Ministry of Science and Higher Education of Poland entitled "Best of the best! 2.0 ".